Red flags — seek medical review if:
- The head consistently turns or tilts to one side and does not vary with gentle encouragement.
- A firm lump is felt in the side of the neck.
- A flat spot is worsening, very pronounced, or asymmetric enough to change the shape or alignment of the face or ears.
- Reduced or unusual movement in one arm or leg alongside the head preference, which needs broader assessment.
If your baby has a fever, remember: fever of 38°C or more in a baby under 3 months is an emergency — do not give paracetamol and wait; seek urgent medical care.
Why this has become a bigger topic
Since safe-sleep guidance rightly moved almost all babies to sleeping on their backs, the amount of time a young baby's head spends resting against a flat surface has increased. This is unquestionably the right trade-off for reducing sleep-related risk, but it has also meant that giving babies supervised time on their tummies while awake, and varying the position of their head during sleep and carrying, has become an important complementary habit — one that supports neck, shoulder, and upper body strength and helps even out pressure on the skull.
Head shape
A newborn's skull is made of separate bony plates that have not yet fused, which allows the head to be moulded a little during birth and also means it can flatten in one spot with prolonged, repeated pressure — most often at the back of the head from lying on the back for sleep and from time in car seats, swings, or bouncers. Mild, temporary flattening is very common and usually improves on its own over months as the baby spends more time upright, sitting, and moving. A more pronounced or one-sided flat spot (sometimes called positional plagiocephaly) is worth mentioning to a health visitor or doctor, particularly if it is not gradually improving with repositioning efforts.
Torticollis
Torticollis describes a tendency for a baby to hold or turn their head consistently to one side, sometimes with a small firm lump felt in the neck muscle on that side. It is often related to the baby's position in the womb or to birth, and it commonly appears alongside a flat spot on the same side of the head, since the two reinforce each other — a head that habitually turns one way rests longer on the same spot. Many mild cases improve with simple repositioning and stretching guided by a health professional, and outcomes are generally very good, especially the earlier it is identified.
What helps
- Supervised tummy time on a firm surface while the baby is awake and alert, starting with short spells several times a day and building up gradually.
- Alternating which end of the cot the baby's head faces on different nights, and alternating which side you approach the baby from for feeding, talking, and play, to encourage turning both ways.
- Carrying the baby on alternating arms/shoulders rather than always the same side.
- Limiting extended time in car seats, swings, and bouncers to travel and short spells rather than long stretches of awake time.
- Never leaving a baby unsupervised during tummy time, even briefly.
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Message us on WhatsAppClinical thresholds in this page were reviewed and signed off by Dr Didier Decamps on 17 August 2026. This is general information and does not replace an individual assessment by a qualified clinician.
Written with AI assistance. Reviewed, corrected and signed by Dr Didier Decamps, paediatrician.
Last reviewed: 17 August 2026